SBS MEDICAL WAIVER
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  • PLEASE SELECT Riding Level and Experience:

    Preginner---no experience

    Beginner--experience, pony rides, or few lessons, less than one year

    Intermediate--some experience, proficient at the walk/trot off lead, riding for a year or more

    Advanced--proficient at the walk, trot, canter, 3 ore more years of experience Please explain any previous riding and/or horse experience/s:

  • TO ANY DOCTOR OR HOSPITAL: I hereby authorize the release of my child's pertinent medical information to the appropriate professional staff. I give permission to the physician or hospital to secure treatment for him/her and to order medications, injections, anesthesia, or surgery for my child, as named above, in case of emergency. The signature below constitutes authorization to perform any necessary treatment for my child during this field trip.

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  • By signing above, I hereby state that I am in receipt of and in agreement of the equine liability waiver, signed, releasing all liability of HERO. LLC and Sunny Brook Stables and its representatives. Additionally, releasing all liability of potential Covid-19 exposure and/or any other health concern related to barn life, equine, and/or any other type of health or medical incident Liability waiver also acknowledges permission for photography during camp. I also acknowledge that I have reviewed the stable rules, policies, and procedures.

    Please complete and email this form to sunnybrookstablesga@gmail.com Payment is due via Venmo to @Grania- Holman or Zelle 678-234-2414 before dates and days can be confirmed for camp. Refunds cannot be given, but credits received for camps can be transferred to lessons, other camps, clinics, SBS Academy, and/or any SBS sponsored or related events. We run camp rain or shine unless there is dangerous inclement weather.

    Is there anything you would like the SBS staff to know about your child and/or anything that may affect his or her safety around equine? No Yes

  • Call Dr. Grania Gothard Holman at 678-234-2414 with questions. Or email sunnybrookstablesga@gmail.com

    Confirmation of your payment, registration, and approved weeks or days will be completed via email. If you do not receive a confirmation email, please notify us. All campers must bring their own lunch, snacks, and water bottles. Riders must weigh under 150 lbs. If questionable, we may ask for a doctor's note for verification. Please use sunscreen before attending. Closed toed shoes and pants are required for riding. Drop off and pick up times are firm. Children may not be dropped off early, and parents must sign their children in and sign them out before dropping off and picking up. Every 15 minutes late for pick up will result in an additional $10 charge. Only the legal guardians and individual/s signing this camp form may drop off and pick up the camper. ID is required at pick up. Please park at the church adjacent to our stables and walk down to meet in the pavilion at drop off and pick up. Most camp days are rain or shine, however, inclement weather and thunderstorms will result in closure of camp

  • for the duration of the weather event. Rescheduled days will be discussed and/or credits for future camps given. No refunds will be issued for any reason. Please come to camp the first day with your receipt of registration and payment. Any child without the receipt will not be allowed to stay for camp. There will be a 15 minute mandatory parent meeting at 10 am the first day of camp and the waivers must be signed in person. Refunds will not be processed for any reason. Please note that we are not a daycare service and my business does not qualify as a day camp provider for tax incentives. We are also not a non-profit. We are a private, for-profit business and operate as such. SBS Camps are dedicated to providing a holistic and comprehensive immersive experience related to all things farm life, horse care, equine, and equestrian sport with our delightful horses, honies, ponies, and donkey with a focus on safety and the introductory rider and horseman. Children learn how to groom, tack, lead, care for, and interact with the horses and ponies in a highly structured learning environment. The curriculum is founded on horsemanship standards based on Pony Club of America learning principles. Campers participate in horse related games and activities, have interactive experiences with the horses and ponies, ride for pleasure, and have a lesson of the day. We offer creative arts lessons and Spanish also related to equine. Dr. Grania is a career educator with a doctorate in education, and so the focus of camp is on horsemanship and the love of the animals, all while engaging in learning activities. Intensive private riding instruction is reserved for our lesson program and SBS Academy. All campers are welcome to also participate in our lesson program. Thank you for your business! The SBS Family Version January 2023

    EQUINE RELEASE, WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

    BY SIGNING THIS AGREEMENT, YOU ARE GIVING UP CERTAIN LEGAL RIGHTS. READ THIS AGREEMENT CAREFULLYAND FULLY UNDERSTAND IT BEFORE SIGNING IT.

    FullLegal Name of Minor Child's & Parent(s) or Guardian(s):

  • (both Parents/Guardians to sign this document

  • WARNING: Riding, training, petting, feeding, watching or merely being in the vicinity of horses and other farm animals - and beling on farm property - presents unavoidable risks and dangers. These risks and dangers, include, without limitation (it being impossible to list every otential risk and danger you may encounter during equine-related events, but this Agreement applies to all of them, whether stated or unstated): Bites, kicks or other unexpected or aggressive behavior of the animals such as being thrown, bucked off or butted Cuts, scratches or other injuries caused by the animals, stalls, gates or fences Accidents such as falling off horses, horses falling/stepping on participants or being dragged by a foot/arm caught in stirrups Allergic reactions to animals, insects, hay or other allergens and/or bites or scratches caused by reptiles, insects or animals Falling, slipping or tripping in holes, wet areas, or on materials or equipment Colliding with or being hit by vehicles, farm equipment (mobile or stationary) or farm animals Being injured by another (human) participant and/or their pets or vehicles

    FURTBER AND ADDITIONALLY, UNDER GEORGIA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES, PURSUANT TO CHAPTER 12 OF TITLE 4 OF THE OFFICIAL CODE OF GEORGIA ANNOTATED.

    YOU AGREE THAT THIS AGREEMENT WILL APPLY EACH AND EVERY TIME THAT YOU AND/OR YOUR MINOR CHILD(REN) PARTICIPATE IN ANY EQUINE RELATED ACTIVITY ON THE PREMISES, ARE PRESENT ON THE PREMISES, ARE ON YOU WAY INTO OR OUT OF THE PREMISES, OR AT THE PREMISES WHILE INVOLVED IN OR OBSERVING EQUINE RELATED ACTINITIES. NO ADDITIONAL FORM WILL BE REQUIRED TO BE SIGNED EACH TIME YOU AND/OR YOUR MINOR CHILD(REN) PARTICI PATE. YOU AGREE NOT TO BRING ANYONE ONTO THE PREMISES, OR ALLOW ANYONE TO ENTER UPON THE PREMISES TO OBSERVE RELATEDSIGNEDYOU PARTICIPATEOREQUINEACTIVITIES,WHOHASNOTAN AGREEMENT. FURTHER,AGREE

  • TO FULLY DEFEND AND INDEMNIFY THE EQUINE PARTIES (AS DEFINED BELOW) IF AN INDIVIDUAL WHO HAS NOT GNED AN AGREEMENT MAKES A CLAIM AGAINST AN EQUINE PARTY.

    In consideration of you and/or your Minor Child(ren) identified herein (together with any invitees or guests accompanying youbeing permitted to participate in, monitor, observe, or engage in any way in any equine-related activity or events conducted at, upon or appurtenarito the premises located at Sunny Brook Stables (including all or some of the riding areas, stables, paddocks, roadways, pathways, buildings (collectively.the "Activifies"), I/We (including as parent(s) or guardian(s) of the Minor Child(ren) named herein, for himself/herself, the Minor Child(ren), you guests and invitees and his/her personal representatives, heirs and next of kin of the foregoing (collectively, the "Releasing Parties"): (1) hereby releases, waives, discharges and covenants not to sue or bring any action against HERO, LLC and/or any of the members, officers, employees, agents, andand assignees, therepresentatives, operatorssuccessors,legalexecuters administrators of any of the foregoing (collectively, the "Equine Parties"), from any and all damages, claims, causes of action, obligations, liabilities,or demands on account of bodily injury, personal injury, death or property damage or loss however caused (whether arising from lack of control or supervision, providing or failing to provide ambulance service, medical care, nursing care, paramedic care, basic life support care, emergency trauma care, advance life support care, first aid emergency communication, emergency transportation, or the design, maintenance or repair or lack thered to the Premises or of any other act or omission caused the Equine Parties or otherwise) while the Releasing Parties are upon the Premises or while the in.orinthedefendand ReleasingPartiesis/areparticipatingmonitoring.observinginengagingActivities:(2)herebytoindemnify, anyagrees way save and hold harmless the Equine Parties and each of them from any and all loss, liability, claims, damage, actions, cost or expense (including|but not limited to, attomeys' fees and disbursements, ) they may incur due to the Releasing Parties participating in. monitoring, observing or in any way engaging in the Activities; (3) hereby assumes full responsibility for any and all risks of bodily injury, death or property damage to the Releasing Parties while participating in. monitoring, observing and/or in any way engaging in the Activities and hereby assumes full responsibility for the Releasibs Parties' safety; (4) hereby expressly acknowledges and agrees that the Activities are dangerous, ultra-hazardous and involve the riskof serious injury and/or death and/or property damage (for instance the propensity of equines to behave in ways which may result in injury, harm or even death to humans or other animals around or near them; the unpredictability of equine reaction to such things as sounds, sudden movements, smells (e.g. shy suddenly, rear, stop short or run with its rider and unfamiliar objects, persons or other animals; hazards related to surface and subsurface conditions; collisions with other equines or objects; the extremely strong, powerful, heavy and unpredicted nature of horses; and, the potential ofa participant to act in a negligent or unskilled manner which may contribute to injury to the participant or others, including. without limitation, falling or inability to maintain control over the animal or not acting within his or her ability) and that the Releasing Parties consciously and voluntarily assume all (5)thattheReleasingPartiesare herebyagree spedifically releasing the Equine Parties from their own negligence; (6) hereby agree to be responsible for all damage caused by the Releasing Parties and their animalsandconsentsandholdsthefrommedicalorortreatmentand Equine (7)herebyto,herebyharmless,Parties,anyx-ray,anesthetic.diagnosis emergepey or hospital service or first aid that may be rendered, including under the general or specific guidance of the EMT. medic, physician, nurse, or hospital [the undersigned acknowledges that this consent to medical treatment is given in advance of any specific diagnosis or treatment that may be required) and the undersigned agrees to pay all fees of expenses and doctors, hospitals, ambulances and medical interventions necessary hat are incurred.

    insurers, trainers, volunteers,contractors,

    hazards inherent andincircumstances; under these

    I authorize the Equine Parties to photograph, reproduce and distribute me and/or my Minor Child(ren)'s photograph, photographic likeness videotaped image and or testimonial, individually and/or incorporated into any other works, for any lawful purpose, including, but not limited to the adrertising and/or promotion of and by the Equine Parties, including but not limited to. on and via their social media accounts and/o press doverage. I understand that I am not entitled to compensation for the use of any of the foregoing materials.

    In the ovent of any litigation against the Equine Parties arising directly or indirectly from the Activities or this Agreement, such litigation shall befiled it Cobb inSuchfiled exclusifelyCounty,Georgia.litigationmustbewithinoneoftheactoroccurrencethatrisetotheclaim(s)asferted gives (1) year such litgation. Each of the Releasing Parties further expressly agrees that this Agreement is intended to be as broad and inclusive as is permitted by the law of he State of Georgia, and that if any portion thereof is invalid, it is agreed that the balance shall, notwithstanding, continue to be in full legal force andeffect.

    .not attempt an equine activity that I do not feel prepared to or able to undertake or to ride a horse I do not feel I am able to manage. I understand that the Equine Parties do not warrant or represent the safety, quality or character of any horse loarled, frowed, leased, or owned by any Equine Party or used by me under instruction or otherwise. .I agree to inspect the Premises for hazards before riding on the Premises, as well as taking sole responsibility for my well-being while entering and exiting the Premises. I understand that the Equine Parties do not assure my safety or have any obligation to inspect and/or repair the Premises. .I understand and agree that I am releasing the Equine Parties from any liability from teaching me any horseback riding skills or providing any training or equipment. .I agree to wear a well-fitting protective helmet, hard hat or similar protective headgear which meets or surpasses ASTMISEI standards, fastened securely under my chin while working around or riding horses and to always wear hard-soled, fully enclosed bopts with heel while working around or riding horses. The Equine Parties shall not be responsible to see to it that I use this salfety equipment it being your sole responsibility to do so.

  • I hereb) declare that I am of legal age and am competent to sign this Agreement. Having read the proceeding, I acknowledge a full and complete understinding of limitations and liabilities and waiver of certain rights and granting of releases contained herein and knowingly consent thereto. I understand that this Agreement does not expire and cannot be revoked or rescinded.

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  • NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN PURSUANT TO §O.C.G.A. 29-2-3: YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY AND THAT YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY. BY SIGNING THIS AGREEMENT, YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM THE EQUINE PARTIES IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH TO YOUR CHILD OR ANY PROPERTY DAMAGE AS DESCRIBED HEREIN. YOUHAVETHERIGHTTOREFUSETOTHISANDEQUINEPARTIESHAVETHERIGHTTOREFUSE THE SIGNAGREEMENT, TO (ET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN.

    The undersigned represent(s) that he/she (they) is (are), in fact, the parent(s) or natural or legal guardian(s) of the Minor Child(reh and hereby agree to save and hold harmless and indemnify each and all of the Equine Parties from all liability, loss, cost, claim or damage whatsoever that may be imposed upon any Equine Parties because of any defect in or lack of such capacity to execute this Agréement on ohalf of, and lawfully bind, the Minor Child(ren Parent/Guardian No. 1, Individually and in a Representative Capacity:

    Parent/Guardian No. 2, Individually and in a Representative Capacity:

    Printed Name: Signed: Date: Witness:

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  • Printed Name: Signed: Date: Witness:

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